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Central vascular Access Devices Nicola York Clinical Nurse Manager Vascular Access Oxford Radcliffe Hospitals NHS Trust 2008.

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Presentation on theme: "Central vascular Access Devices Nicola York Clinical Nurse Manager Vascular Access Oxford Radcliffe Hospitals NHS Trust 2008."— Presentation transcript:

1 Central vascular Access Devices Nicola York Clinical Nurse Manager Vascular Access Oxford Radcliffe Hospitals NHS Trust 2008

2 Temporary CVC

3 Temporary Central Venous Catheters (CVC) Inserted into internal jugular or subclavain veins (occasionally external jugular and femoral veins) Inserted into internal jugular or subclavain veins (occasionally external jugular and femoral veins) Usually inserted prior to major surgery Usually inserted prior to major surgery Catheters are impregnated with anti microbial –silver sulphonamide and chlorhexidine. This extends their use to 8 days. Catheters are impregnated with anti microbial –silver sulphonamide and chlorhexidine. This extends their use to 8 days. Catheters have 3-4 lumens. Catheters have 3-4 lumens.

4 Temporary Central Venous Catheters (cont) Used to administer fluids, blood products, all intravenous drugs and parenteral nutrition. Used to administer fluids, blood products, all intravenous drugs and parenteral nutrition. Central Venous Pressure (CVP) can be monitored from the distal lumen. Central Venous Pressure (CVP) can be monitored from the distal lumen cm catheter inserted cm catheter inserted. Tip of catheter lies in lower third of superior vena cava. Tip of catheter lies in lower third of superior vena cava. Chest x-ray done post insertion to confirm catheter tip position and exclude pneumothorax. Chest x-ray done post insertion to confirm catheter tip position and exclude pneumothorax.

5 PICC

6 Peripherally Inserted Central Catheters (PICC) Inserted into ante-cubital veins under palpation or upper arm veins using ultrasound guidance. Inserted into ante-cubital veins under palpation or upper arm veins using ultrasound guidance cm catheter inserted cm catheter inserted. Catheters have 1-2 lumens. Catheters have 1-2 lumens. Tip of catheter lies in lower third of superior vena cava. Tip of catheter lies in lower third of superior vena cava. Tip position must be verified on chest x-ray. Tip position must be verified on chest x-ray.

7 Peripherally Inserted Central Catheters (cont) Used for months, often up to a year. Used for months, often up to a year. Used to administer long term antibiotics, chemotherapy and parenteral nutrition. Used to administer long term antibiotics, chemotherapy and parenteral nutrition. Can be used for blood sampling. Can be used for blood sampling. Patients can go home with device in situ. Patients can go home with device in situ.

8 Tunnelled CVC

9 Tunnelled Central Venous Catheters Inserted into internal jugular or subclavian veins (occasionally femoral veins). Inserted into internal jugular or subclavian veins (occasionally femoral veins). End is tunnelled subcutaneously – can be cuffed or non-cuffed. End is tunnelled subcutaneously – can be cuffed or non-cuffed. Catheters have 1-3 lumens. Catheters have 1-3 lumens. Tip of catheter lies in lower third of superior vena cava. Tip of catheter lies in lower third of superior vena cava. Chest x-ray done post insertion to confirm catheter tip position and exclude pneumothorax. Chest x-ray done post insertion to confirm catheter tip position and exclude pneumothorax.

10 Tunnelled Central Venous Catheters (cont) Used for months, often years. Used for months, often years. Used to administer long term antibiotics, chemotherapy and parenteral nutrition. Used to administer long term antibiotics, chemotherapy and parenteral nutrition. Can be used for blood sampling. Can be used for blood sampling. Patients can go home with device in situ. Patients can go home with device in situ. Minor procedure to remove cuffed catheters. Minor procedure to remove cuffed catheters.

11 Portacath

12 Portacaths Inserted into internal jugular or subclavian veins (occasionally femoral veins). Inserted into internal jugular or subclavian veins (occasionally femoral veins). Reservoir at end of catheter is buried subcutaneously. Reservoir at end of catheter is buried subcutaneously. Reservoir is accessed with gripper needle. Reservoir is accessed with gripper needle. Tip of catheter lies in lower third of superior vena cava. Tip of catheter lies in lower third of superior vena cava.

13 Portacaths (cont) Chest x-ray done post insertion to confirm catheter tip position and exclude pneumothorax. Chest x-ray done post insertion to confirm catheter tip position and exclude pneumothorax. Used in patients who require life-long intravenous therapies. Used in patients who require life-long intravenous therapies. Improves quality of life e.g. more discreet, can swim. Improves quality of life e.g. more discreet, can swim.


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